Relationship Between Plasma Glutathione-s Transferase Levels And Acute Intestinal Ischemia In Wistar Rats

Objective To investigate the kinetics of plasma glutathione-s transferase (GST), D-lactate (DLA) and creatine kinase (CK) levels in Wistar rats suffered acute intestinal injury in respect to explore the early diagnostic markers for this disease.Methods Seventy Wistar rats were randomly divided into seven groups: the sham operation group, six mesentery ischemia groups at different time points, 15min, 30min, lh, 1.5h, 2h, and 3h, for testing plasma GST, DLA, and CK levels after intestinal injury occurred. Every group had 10 rats. The intestinal ischemia model was made by ligating superior mesenteric artery (SMA) to obstruct the blood flow. Standard for an absolute obstruct: after the ligating point, no pulse can be felt. The intestine gets pale and cold. The levels of plasma GST, DLA, and CK, were determined in each group. The morphological changes of intestinal tissues were evaluated by subjecting the injured intestinal samples to HE staining. The results of plasma levels and intestinal morphological changes were subject to correlation analysis to determine the relationship between them.Results 1. The ischemic injury of small intestine started from the tip of the intestinal villus, and develop towards the deep part of the intestinal wall. The HE stain evaluation scores of the intestinal ischemia injury rose as ischemia time went on and were significantly correlated to the levels of plasma GST, DLA and CK.2. Plasma GST was sensitive to intestinal ischemia and a significant increase was first observed at 15rain (P-0.05) and lasted for 2 hours; Taking GST=16.91U/L as a diagnostic standard for intestinal ischemia, the sensitivity, specificity and accuracy were 91.67%(55/60), 70%(7/10) and 88.57%(62/70)respectively.3. Plasma DLA level show a significant increase at 1h after ischemia occurred (P=0.05), and kept a gently raising tendency then on; If taking DLA=0.687μg/L as diagnostic standard, its sensitivity, specificity and accuracy were 76.7%(46/60), 90%(9/10), 74.86%(52/70) respectively.4. The level of plasma CK first increased at 1.5h, and showed a dramatically increase at 2h and kept this tendency from then on; To diagnose acute intestinal ischemia with plasma CK=217.11 U/L, the sensitivity, specificity and accuracy was 70%(42/60), 80%(8/10), 71.43%(50/70) respectively.Conclusion1. The ischemic injury of small intestine starts from the tip of the intestinal villus, and develops towards the deep part of the intestinal wall; the intestinal ischemia injury is aggravated as ischemia time goes on.2. Plasma GST may be a useful marker of early diagnosis of intestinal ischemia. A rapid elevation may suggest a poor prognosis.3. Plasma DLA does little help to early diagnosis of intestinal ischemia, but it plays a great role in diagnosis of intestinal ischemia with a high diagnostic specificity.4. In intestinal ischemia, a high level of plasma CK does more in prompting an unfavorable prognosis than in diagnosis.